561 Pakistan Oral & Dental Journal Vol 32, No.

3 (December 2012)
Evaluation of Oral Function after Removable Partial Denture Therapy
ORIGINAL ARTICLE
Correspondence:
1
Assistant Professor, Department of Prosthodontics, de,Montmorency College of Dentistry, Ravi Road Lahore. E-mail: drashsad@gmail.com
Cell No: 0321-4149089. Mailing Address: N-14 Cantt view Housing Scheme Bedian Road Lahore.
2
Professor & Dean Fatima Memorial Institute of Dentistry, Shadman Lahore. Email: nazia508@gmail.com. Cell No: 0333-4317508
3
Head Dental Department, CMH, Muzaffarabad
INTRODUCTION
Tooth loss results in deterioration of functional,
psychological and social status of an individual.
1
Re-
movable partial denture represents one of the major
treatment modalities for the replacement of missing
teeth.
2
There are also some practical problems with
removable partial dentures such as food retention,
difficulty in pronouncing words and pressure spots
3
.
Their success is often judged differently by patients
and dentists.
4,5
Dentists consider dentures successful
when they meet certain technical standards, whereas
patient evaluate them from their personal satisfaction
.Therefore, even if they are constructed according to
all accepted criteria, some patients are still
dissatisfied.
6,7
In the literature
8,9,10
there is a strong support for
the patient based measures than the functional mea-
sures for detecting the differences between the treat-
ment and psychosocial consequences of the oral condi-
tion. Thus the knowledge about patients use of remov-
able partial denture would be helpful to both the
dentist and patient, when making a decision about a
prosthodontic treatment option.
Studies
11,12
show that clinicians judgment corre-
lates quite poorly with patients judgment about com-
fort, esthetics and function of removable partial den-
tures. Therefore the aim of present study was to
evaluate the oral functional problems after provision
of removable partial dentures from patients
perspective.
EVALUATION OF ORAL FUNCTION AFTER REMOVABLE PARTIAL
DENTURE THERAPY
1
AYESHA SADAF, BSC, BDS, FCPS
2
NAZIA YAZDANIE, BDS, MSC, PhD
3
AQEEL IBRAHIM, BDS, FCPS
ABSTRACT
This study aimed to evaluate the oral function after removable partial denture therapy from
patients perspective. It was a descriptive case series. One hundred and ten partially dentate subjects
were studied in the Department of Prosthodontics, de, Montmorency college of dentistry, Lahore. All
the subjects were given oral health impact profile -14 questionnaire before and one month after
provision of removable partial denture. Before and after treatment responses were recorded on 5 point
Lickert scale. The post treatment scores were compared with pretreatment baseline scores and
improvement in oral functional problems were assessed. 96% of study subjects had problems in
pronouncing words, which persisted in 56% of the subjects after using removable partial denture . 94%
of the study group had taste problems before removable partial denture treatment, which improved
in 50% of study population after therapy. This suggested that removable partial dentures had a
positive impact on oral function in almost half of the population. Lack of improvement in remaining
group can be attributed to lack of education and awareness which was responsible for negative attitude
of these patients towards removable partial dentures.
Key Words: Removable partial denture, Lickert scale, Oral health impact profile.
562 Pakistan Oral & Dental Journal Vol 32, No. 3 (December 2012)
Evaluation of Oral Function after Removable Partial Denture Therapy
METHODOLOGY
It was a descriptive case series. Non-Probability
sampling technique was used. Partially dentate sub-
jects with 4-5 teeth missing in either arch with age
range of 35-45 years and first time denture wearers
were included in the study. Study sample consisted of
one hundred and ten partially dentate subjects with 4-
5 missing teeth in either arch visiting Department of
Prosthodontics, Punjab Dental Hospital Lahore and
requesting removable partial denture for the first
time. Informed consent was taken from each subject.
Patients underwent a history and clinical examina-
tion. Patients were asked to answer a questionnaire on
socio-demographic factors. In addition a self adminis-
tered questionnaire called Oral health impact profile -
14
13
was used for patient based assessment of oral
functional problems i.e. problems in speech and sensa-
tion of taste. The questionnaire consisted of 14 ques-
tions which covered 7 domains namely functional
limitation, physical pain, psychological discomfort,
physical disability, social disability and handicap. Only
one domain i.e. functional limitation was selected for
the present study. Responses by subjects were made
on 5 point Lickert scale
14
and coded as (0 = Never, 1=
Hardly ever, 2 = Occasionally, 3= Fairly often, 4= Very
often). The Prosthodontic procedures were carried out
by experienced Prosthodontists. All study subjects
were subjected to answer the oral health impact pro-
file-14 before treatment and one month after provision
of removable partial denture. The post treatment
scores were compared with pretreatment baseline
scores . Confounding variables i.e. age , number of
missing teeth, experience of denture wearing and
prosthodontic treatment modality were controlled and
being addressed in inclusion criteria.
SPSS software version 16.0 was used to analyze
the data. The demographic variables (age, gender and
occupation) were analyzed using simple descriptive
statistics. Age was presented by calculating Mean
+
-
S.D. Gender and responses of questions were repre-
sented by calculating percentages and frequencies.
RESULTS
DISCUSSION
Patient perception of oral health status are impor-
tant outcomes in Prosthodontics
15
.Oral health prob-
lems experienced by the patients seeking Prosthodontic
treatment are important for diagnosis and success of
TABLE 1: DISTRIBUTION OF AGE OF THE
SUBJECTS
Age range (years) No. of patients
35-40 years 43
40-45 years 67
Total 110
Mean + S.D = 41.1
+
2.91
TABLE 2: GENDER DISTRIBUTION
Gender No. of patients Percentage
Males 53 48.0
Females 57 52.0
Total 110 100
TABLE 3: NUMBER & PERCENTAGE OF PA-
TIENTS ACCORDING TO DIFFICULTY IN PRO-
NOUNCING WORDS AND PROBLEMS
ASSOCIATED WITH TASTE
Oral functional Pre-treat- Post-treat-
problem ment n (%) ment n (%)
Difficulty in pro- 105 (96%) 61 (56%)
nouncing
Problems with taste 103 (94%) 55 (50%)
TABLE 5: DISTRIBUTION OF PATIENTS AC-
CORDING TO RESPONSES ON LIKERT SCALE
FOR PROBLEMS ASSOCIATED WITH TASTE
Responses Before fre- After fre- Level of
quency quency signifi-
cance
Never 9 11 P > 0.001
Hardly ever 26 43 P < 0.001
Occasionally 18 36 P < 0.001
Fairly often 34 7 P < 0.001
Very often 13 3 P < 0.001
TABLE 4: DISTRIBUTION OF PATIENTS AC-
CORDING TO RESPONSES ON LICKERT SCALE
FOR DIFFICULTY IN PRONOUNCING WORDS
Responses Before fre- After fre- Level of
quency quency signifi-
cance
Never 3 6 P > 0.001
Hardly ever 16 29 P < 0.001
Occasionally 9 54 P < 0.001
Fairly often 48 11 P < 0.001
Very often 24 0 P < 0.001
563 Pakistan Oral & Dental Journal Vol 32, No. 3 (December 2012)
Evaluation of Oral Function after Removable Partial Denture Therapy
Prosthodontic therapy. The present study has shown
the frequency and degree of oral functional problems
under the domain of functional limitation. The study
population was homogenous in relation to gender and
age, as the same groups were analyzed before and after
the treatment. This is in agreement with Zaltaric et al
9
.
In the present study , the majority of the patients
(96%) showed problem in pronouncing words before
removable partial denture therapy. This suggests that
patients encountered speech problems due to missing
teeth and after removable partial denture therapy,
this problem was solved. This is in agreement with
studies of Kuboki et al
15
and John et al.
16
In the present
study the significant increase in oral health impact
profile scores in half of population (56%) suggested
increase in speech problems after removable partial
denture therapy. Similar results have been reported in
a study by Szentpetry et al
3
, who found that greater
percentage of patients (60%) reported speech prob-
lems at an interval of one month. But in a study by
John et al,
16
21% of the population showed difficulty in
pronouncing words after removable partial denture
therapy. Speech is a complex skill requiring prolong
adaptation to polish surface and shape of prosthesis,
thus lack of improvement in present study may be
attributed due to shorter review period.
17
The small sample size of one hundred and ten
subjects was the limitation of this study. This sample
size did not allow detailed analyses of results accord-
ing to the different Kennedys classes of partially den-
tate subjects. It has been reported that patients are
least satisfied with distal extension bases.
15
Future
studies should use more distinct patient groups e.g.
patients with different Kennedys classes and different
denture design.
In the present study, there was an increase in
problem of altered taste sensation after removable
partial denture therapy . Szentpetry et al
5
and John et
al
16
also showed the similar results after treatment but
the affected study population was small i.e. 20% and
30% respectively. The increase in taste problem with
removable partial denture in the present study popu-
lation could be due to lack of education and awareness
which was responsible for the negative attitude of
these patients towards removable partial denture
therapy. Therefore more efforts should be made in
order to educate denture wearers.
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